Fluoxetine in the management of chronic itch in a cat
A case report
Fluoxetine in the management of chronic itch in a cat: a case report
Authors
Maria Beatrice Conti
Centro di Ricerca sul Dolore Animale (CeRiDA), Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Italy
Chiara Brachelente
Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Italy
Alessandra Di Salvo
Centro di Ricerca sul Dolore Animale (CeRiDA), Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Italy
Giorgia Della Rocca
Centro di Ricerca sul Dolore Animale (CeRiDA), Dipartimento di Medicina Veterinaria, Università degli Studi di Perugia, Italy
Summary
Background – Chronic itch is a common finding in many inflammatory/allergic skin diseases and systemic disorders in cats. However, it could also have a neuropathic origin, that leads to dramatic self-trauma injuries, often refractory to any conventional symptomatic therapy.
Case report – An approximately two-year-old male neutered domestic short hair cat was brought in with severe ulcerative dermatosis localized in the neck region, that was associated to compulsory scratching. The diagnostic protocol failed to determine the underlying cause, although a hypersensitivity dermatitis was suspected. However, immunosuppressant therapy did not control itch. Suspecting a neuropathic itch syndrome, a treatment with gabapentin was attempted, although scarcely effective. Conversely, fluoxetine (0.4 mg/kg PO twice daily) brought about in a couple of weeks a marked reduction in selftrauma injuries, which were completely healed two months later. Fluoxetine was maintained at the same dosage for two years, as itching relapsed at any attempt to taper the drug; no side effects were noticed. Now, five years after the onset of the treatment, the cat is still receiving the full dose every other day and his behavior is normal.
Conclusions and clinical importance – Fluoxetine, a selective serotonin re-uptake inhibitor, was the only drug that was able to solve the severe chronic itch seen in this cat, likely related to a neuropathic origin. The prolonged therapy was safe, as no side effects were observed.
Keywords
cat, neuropathic itch, fluoxetine
